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Anemia and retinopathy of prematurity: A narrative review
Minali Prasad1, David Dombrovsky2, Stephen P Christiansen3,4
1Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts USA.
Insights
Retinopathy of prematurity (ROP) and anemia frequently occur together in premature infants. Further research is needed to clarify their complex relationship and the role of iron in infant eye disease.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Hematology
Background:
- Retinopathy of prematurity (ROP) and anemia are common in preterm infants.
- The precise relationship between ROP and anemia is not well understood.
- Confounding factors and varied study designs complicate existing research.
Purpose of the Study:
- To explore the association between retinopathy of prematurity and anemia in infants.
- To investigate potential molecular mechanisms linking ROP and anemia.
- To highlight the need for further research, including clinical trials.
Main Methods:
- Review of prospective and retrospective studies.
- Analysis of molecular mechanisms: hypoxia, oxidative stress, inflammation.
- Consideration of iron homeostasis disruptions.
Main Results:
- The association between ROP and anemia is complex and influenced by other prematurity comorbidities.
- Molecular pathways like hypoxia, oxidative stress, and inflammation may play a role.
- Iron deficiency or overload has been linked to ROP development.
Conclusions:
- The exact relationship between ROP and anemia requires further investigation.
- The timing of anemia onset relative to ROP phases is a critical factor.
- Randomized clinical trials are necessary to clarify this association and the impact of anemia timing.
Abstract:
Retinopathy of prematurity (ROP) and anemia are often comorbid in preterm and low birth weight infants in the United States. However, the relationship between ROP and anemia in infants is unclear across prospective and retrospective studies due to confounding from other comorbidities of prematurity and variable study designs. Molecular mechanisms that may underlie this association include tissue hypoxia, oxidative stress, inflammation, and the timing of onset of anemia relative to the phase of ROP. Furthermore, maternal or neonatal disruptions in iron homeostasis, leading to either iron deficiency or accumulation, have been associated with ROP. Further studies, including randomized clinical trials, are needed to better elucidate the association between ROP and anemia, as well as the impact of the timing of the onset of anemia.
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